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Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching

We present a case of pediatric deceased donor liver transplantation using a reduced whole liver graft in a 25-month-old boy weighing 12.7 kg. After he had undergone Kasai portoenterostomy for biliary atresia, his general condition deteriorated progressively. He was enrolled on the waiting list for l...

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Autores principales: Namgoong, Jung-Man, Hwang, Shin, Kim, Dae-Yeon, Ha, Tae-Yong, Song, Gi-Won, Jung, Dong-Hwan, Kim, Kyung Mo, Oh, Seak Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Hepato-Biliary-Pancreatic Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382866/
https://www.ncbi.nlm.nih.gov/pubmed/34402448
http://dx.doi.org/10.14701/ahbps.2021.25.3.431
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author Namgoong, Jung-Man
Hwang, Shin
Kim, Dae-Yeon
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Kim, Kyung Mo
Oh, Seak Hee
author_facet Namgoong, Jung-Man
Hwang, Shin
Kim, Dae-Yeon
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Kim, Kyung Mo
Oh, Seak Hee
author_sort Namgoong, Jung-Man
collection PubMed
description We present a case of pediatric deceased donor liver transplantation using a reduced whole liver graft in a 25-month-old boy weighing 12.7 kg. After he had undergone Kasai portoenterostomy for biliary atresia, his general condition deteriorated progressively. He was enrolled on the waiting list for liver transplantation with Pediatric End-stage Liver Disease score of 15. The donor was a 51-monthold boy with body weight of 20 kg. The donor-to-recipient body weight ratio was 158%. The liver graft appeared to be larger than the recipient’s abdominal cavity. Thus, we planned to do in situ size reduction. Recipient surgery was performed following standard procedures. We performed graft outflow vein reconstruction using a modified piggyback technique like the double inferior vena cava method. Since the portal vein was hypoplastic, a side-to-side anastomosis technique was used. We also performed intraoperative portogram to embolize venous collaterals. After completing the graft implantation, we found that the liver graft was too large to be accommodated within the abdomen. After in situ resection of the left lateral section parenchyma, we successfully performed primary closure of the abdominal wound. This patient experienced episodes of acute rejection. He has been doing well for four years after the transplantation.
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spelling pubmed-83828662021-09-04 Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching Namgoong, Jung-Man Hwang, Shin Kim, Dae-Yeon Ha, Tae-Yong Song, Gi-Won Jung, Dong-Hwan Kim, Kyung Mo Oh, Seak Hee Ann Hepatobiliary Pancreat Surg Case Report We present a case of pediatric deceased donor liver transplantation using a reduced whole liver graft in a 25-month-old boy weighing 12.7 kg. After he had undergone Kasai portoenterostomy for biliary atresia, his general condition deteriorated progressively. He was enrolled on the waiting list for liver transplantation with Pediatric End-stage Liver Disease score of 15. The donor was a 51-monthold boy with body weight of 20 kg. The donor-to-recipient body weight ratio was 158%. The liver graft appeared to be larger than the recipient’s abdominal cavity. Thus, we planned to do in situ size reduction. Recipient surgery was performed following standard procedures. We performed graft outflow vein reconstruction using a modified piggyback technique like the double inferior vena cava method. Since the portal vein was hypoplastic, a side-to-side anastomosis technique was used. We also performed intraoperative portogram to embolize venous collaterals. After completing the graft implantation, we found that the liver graft was too large to be accommodated within the abdomen. After in situ resection of the left lateral section parenchyma, we successfully performed primary closure of the abdominal wound. This patient experienced episodes of acute rejection. He has been doing well for four years after the transplantation. The Korean Association of Hepato-Biliary-Pancreatic Surgery 2021-08-31 2021-08-31 /pmc/articles/PMC8382866/ /pubmed/34402448 http://dx.doi.org/10.14701/ahbps.2021.25.3.431 Text en Copyright © 2021 by The Korean Association of Hepato-Biliary-Pancreatic Surgery https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Namgoong, Jung-Man
Hwang, Shin
Kim, Dae-Yeon
Ha, Tae-Yong
Song, Gi-Won
Jung, Dong-Hwan
Kim, Kyung Mo
Oh, Seak Hee
Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title_full Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title_fullStr Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title_full_unstemmed Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title_short Pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
title_sort pediatric deceased donor liver transplantation with in situ size reduction for recipient-graft size matching
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382866/
https://www.ncbi.nlm.nih.gov/pubmed/34402448
http://dx.doi.org/10.14701/ahbps.2021.25.3.431
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